The impact of a biomimetic nipple on infant performance during breast and bottle feeding

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There are hundreds of varieties of commercially available bottles, yet all of them are designed as a cistern filled with milk, without a system of ducts, emptying directly into the mouth from the nipple. This system is found in cows, but the human breast is comprised of a series of ducts that release milk from multiple glands within the breast. Because of this, the mechanics of breast and bottle feeding differ, and infants often struggle when being introduced to the breast, or conversely, refuse a bottle after exclusive breastfeeding. The ultimate goal of this work is to test and validate a bottle-nipple system in an animal model that matches the physiology and performance of breastfeeding infants better than currently available options. The central hypothesis is that the design of a bottle nipple system that is lactiferous, as is true for humans and our animal model, pigs, rather than cisternic, as is found in cows, will more closely match the infant neurophysiology during breastfeeding than current bottle designs. We will use an accepted and extensively published animal model for infant feeding, pigs, to test this hypothesis by comparing feeding physiology and performance between breastfeeding with bottle feeding on cisternic and ducted nipples. These results will provide a foundation for the implementation of biomimetic bottle designs that will enable successful and optimal sucking and swallowing biomechanics for bottle fed infants. This will be accomplished through two specific aims: (SA1) In three feeding modalities, breastfeeding, commercial bottle/nipple, and biomimetic nipple, characterize the neuromotor pattern and muscle activity during suckling and swallowing using fine wire bipolar EMG in healthy infant pigs; (SA2) For the same three modalities, establish the biomechanical mechanism that infant pigs use to generate intraoral pressure during sucking and swallowing. Both artificial nipples will be the same shape, stiffness, and have the same flow rates, to ensure that the only difference in design that would lead to differences in performance lies in the presence or absence of a duct. The significance of this project lies in the potential to decrease problems associated with introducing bottles or breasts to infants through the design of a biomimetic nipple, and provide infants fed on bottles with the same biomechanical benefits as those fed on the breast. The innovation of this project is the analysis and validation of a biomimetic feeding system based on maternal breast anatomy and its interaction with infant feeding physiology. These results will improve feeding outcomes for infants which currently must be fed on bottles due to various maternal and infant pathophysiologies and take a step towards the optimal design of a bottle/nipple system to enhance infant feeding.